Add-on Antidepressants in the Naturalistic Treatment of Schizophrenia Spectrum Disorder – When, Who, and How?

Author:

Schennach Rebecca12,Obermeier Michael1,Seemüller Florian1,Jäger Markus1,Schmauss Max3,Laux Gerd4,Pfeiffer Herbert5,Naber Dieter6,Schmidt Lutz7,Gaebel Wolfgang8,Klosterkötter Joachim9,Heuser Isabella10,Maier Wolfgang11,Lemke Matthias12,Rüther Eckart13,Klingberg Stefan14,Gastpar Markus15,Spellmann Ilja16,Musil Richard1,Möller Hans-Jürgen1,Riedel Michael117

Affiliation:

1. Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany

2. Schoen Clinic Roseneck, Prien am Chiemsee, Germany

3. Psychiatric Clinic, District Hospital Augsburg, Augsburg, Germany

4. Psychiatric Clinic, Inn-Salzach Hospital, Wasserburg/Inn, Germany

5. Psychiatric Clinic, Isar-Amper Hospital, Munich-Haar, Germany

6. Department of Psychiatry, University of Hamburg, Hamburg, Germany

7. Department of Psychiatry, Johannes Gutenberg-University of Mainz, Mainz, Germany

8. Department of Psychiatry and Psychotherapy, Heinrich-Heine-University, Düsseldorf, Germany

9. Department of Psychiatry, University of Cologne, Köln, Germany

10. Department of Psychiatry, Charite Berlin, Campus Benjamin Franklin, Berlin, Germany

11. Department of Psychiatry, University of Bonn, Bonn, Germany

12. Psychiatric Clinic, Alsterdorf Hospital, Hamburg, Germany

13. Department of Psychiatry, University of Göttingen, Göttingen, Germany

14. Department of Psychiatry, University of Tübingen, Tübingen, Germany

15. Department of Psychiatry, University of Essen, Essen, Germany

16. Psychiatric Clinic, District Hospital Kaufbeuren, Kaufbeuren, Germany

17. Psychiatric Clinic Nordschwarzwald, Calw, Germany

Abstract

Abstract The aim of this study was to evaluate antidepressant add-on treatment within the acute treatment of schizophrenia spectrum disorder patients. Antidepressant add-on was evaluated in 365 patients within a naturalistic multicenter study. Patients with/without antidepressant add-on were compared regarding clinical and treatment-related variables, response and remission, and remission of depressive and negative symptoms. The efficacy of antidepressant add-on treatment was furthermore analyzed applying marginal structure models. Twenty-three percent of the patients received antidepressant add-on for a mean duration of 50.28 (33.42) days. Patients with the diagnosis of a schizoaffective disorder, multiple illness episodes, and a longer duration of their illness as well as those with significantly fewer baseline positive symptoms, more negative and depressive symptoms, more side effects, and less subjective well-being were augmented with antidepressants. At discharge no significant effect of antidepressant add-on treatment was observed in terms of a 25% improvement (p=0.2623), a 50% improvement (p=0.3946), remission (p=0.0552), or remission of depressive (p=0.6336) and negative symptoms (p=0.8756). Also, when analyzing marginal structure models considering the diagnostic subgroups, no significant effect was found. Add-on with antidepressants is common. A final recommendation in terms of this strategy’s efficacy cannot be given.

Publisher

Georg Thieme Verlag KG

Subject

Pharmacology (medical),Psychiatry and Mental health,General Medicine

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